For all legal arrangements related to Guardianships, Foster Parenting, Power of Attorney, changes in Custody, Medical Directives, etc.Please bring the legal documents related to these arrangements to all of your appointments with your Doctor. We must have a current copy of these documents on file in the patient’s medical record.

Can someone else bring my child in to see the doctor?Yes, however, you must send a signed letter giving your written permission to the individual to bring your child to the Doctor for treatment.

Please include the following in the letter:

Your full name

Your child’s full name

Full name of the person bringing in your child

The date of the appointment(s)

Your signature

Your phone #

You may use this

to give another individual permission to bring your child to an appointment with our Doctors. Please complete all areas of the form.

The individual who brings your child will need to bring a photo I.D. and all of the required information for the appointment as listed above (i.e. insurance card(s), referral and/or Auth, etc.), including payment for co-pays and co-insurance.

Minor patients MUST be accompanied to each and every appointment.

The individual authorized to bring the minor patient in must remain present in the office at all times while the patient is being seen and treated by the Doctor.

If your child is brought to the clinic by a relative or friend, payment is still due at the time of service.

Patients Seen by Appointment Only

Every effort is made to treat patients at their scheduled appointment time. There are, however, times when our schedule is delayed due to unforeseen treatments and/or urgent situations. We apologize in advance for any inconvenience if this occurs during your visit to our clinic. We will provide the same level of service if you are need of medical care.

Late Arrivals & Missed AppointmentsPlease help us stay on time by arriving a few minutes early to your appointment. If you arrive late to your scheduled appointment, you may be asked to reschedule, as it causes other patients to wait beyond their scheduled appointment time. Late arrivals will only be seen with the office manager's & physicians's approval and may be asked to wait until the next available appointment time, or may be rescheduled for another day.

We understand that problems may arise that prevent you from making your appointment. However, we ask that you notify our office 24 hours in advance if you need to cancel or reschedule your appointment. This allows us the opportunity to offer the appointment time to others in need of medical care. Failure to cancel or reschedule in advance, or arrive at the time of the appointment, will result in a no-show.

After 3 No-Show appointments, we may ask you to transfer your care to another provider.

Medical Release Authorization

You may use this form:

to request your Medical Records to be transferred to our Doctor(s) from another Healthcare Provider.

You may also use the above form to provide our office with the authorization the release your Medical Record to another Doctor, Provider, Medical Professional or other entity (such as an employer, etc.).

Completion of Forms

Family Medical Leave Act (FMLA), Short Term Disability (STD), Full Disability, or any other work- or school-related forms or document(s) that need(s) to be completed by our office and/or signed by the Doctor require 7-10 business days to review and complete.

Online Patient Portal

Our patients are invited to use our Online Patient Portal, a powerful new tool to take charge of your health. Enjoy popular features like:

Managing payments

Secure messaging with our staff

Request & review appointments

Log on and register today by clicking the link below:

HIPAA Authorization Form

for Family Members/FriendsPatients may complete a HIPAA Authorization form to give permission to all their health care and medical providers and payers to disclose and release their protected health information to person(s) designated on this form. Please click on the below link for a copy of this form:

Worker's Compensation Insurance Claims & On-the-Job Injuries

This Office does NOT accept Worker’s Compensation insurance. If you want to be seen in our office for a work-related injury & have already filed (or plan to file) a Worker’s Compensation claim, please ask to speak with a Manager.